Submission ID 77617

Code OD-3-1
At the end of this workshop, participants will be able to:
Category Medical Education
Type Oral
Will the presenter be a: Other
Presenter Other Faculty
Title A Critical Narrative Analysis of How Clinicians Cope with Challenges Related to Social Determinants of Health in Practice
Background/Purpose Medical curricula are attempting to prepare trainees to address the social determinants of health (SDH), however the life circumstances of patients are often beyond physician control. Little is known about how physicians cope with this dilemma; we sought to examine physician perspectives when faced with this challenge to help better prepare trainees
Methods We undertook a critical analysis of physician narratives. In total, 268 physician-written narrative pieces from four high impact medical journals were screened and 47 met the inclusion criteria and were analyzed.
Results We identified four storylines that described the physician experience and strategies for coping with SDH. In four Helplessness stories, authors experienced emotional distress when they were unable to support their patients. In eight Shortcoming and transformation stories, authors had realizations about shortcomings and shared how these transformed them. In eighteen Doctor-patient relationship stories, authors described how relationships matter and can make a difference. In seventeen System advocacy stories, authors focused on describing the role of the system and the need for advocacy to change it.
Discussion Current approaches to teaching the SDH focus on the role of physicians in recognizing and altering SDH. However, the realities of practice do not easily allow for this and may lead to distress and burnout. There are other ways to cope and make a difference by improving ourselves, investing in getting to know our patients, and advocating for change. These results can help better support trainees for the realities of practice.
Keyword 1 Social determinants of health
Keyword 2 Curriculum development
Keyword 3 Moral distress
Abstract content most relevant to: (check all that apply) Residency Education
Undergraduate Medical Education
Abstract Track - First Choice Wellness and the culture of medicine
Authors Erin Peebles
Rachael Pack
Mark Goldszmidt
Erin Peebles

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